Factors associated with delayed referrals of patients with sepsis from primary to tertiary healthcare in Blantyre, Malawi: a qualitative study.

Background: Sepsis is defined as invasion of pathogens into the blood stream together with the host response to this invasion. Thus, sepsis consists of the systemic inflammatory response syndrome (SIRS)caused by infection. It is a life-threatening condition that requires prompt detection and early definitive medical intervention.

Using ESPEN data for evidence-based control of neglected tropical diseases in sub-Saharan Africa: A comprehensive model-based geostatistical analysis of soil-transmitted helminths.

Background: The Expanded Special Project for the Elimination of Neglected Tropical Diseases (ESPEN) was launched in 2019 by the World Health Organization and African nations to combat Neglected Tropical Diseases (NTDs), including Soil-transmitted helminths (STH), which still affect over 1.5 billion people globally. In this study, we present a comprehensive geostatistical analysis of publicly available STH survey data from ESPEN to delineate inter-country disparities in STH prevalence and its environmental drivers while highlighting the strengths and limitations that arise from the use of the ESPEN data.

Determinants of gender-equitable attitudes among adult men in a health education program: a cross-sectional study in Southern Malawi.

Background: Malawi ranks 142 out of 170 countries on the UN's Gender Inequality Index (GII). Women and men in Malawi have unequal access to and control over resources. Previous research has primarily examined gender roles and norms from a women's perspective, but few studies have investigated men's attitudes and behaviors regarding gender equality.

Weekly dihydroartemisinin-piperaquine versus monthly sulfadoxine-pyrimethamine for malaria chemoprevention in children with sickle cell anaemia in Uganda and Malawi (CHEMCHA): a randomised, double-blind, placebo-controlled trial.

Background: In many sub-Saharan African countries, it is recommended that children with sickle cell anaemia receive malaria chemoprevention with monthly sulfadoxine-pyrimethamine or daily proguanil as the standard of care. However, the efficacy of these interventions is compromised by high-grade antifolate resistance of Plasmodium falciparum and poor adherence. We aimed to compare the efficacy of weekly dihydroartemisinin-piperaquine and monthly sulfadoxine-pyrimethamine for the prevention of clinical malaria in children with sickle cell anaemia in areas with high-grade sulfadoxine-pyrimethamine resistance of P falciparum in Uganda and Malawi.

Context-Tailored Food-Based Nutrition Education and Counseling for Pregnant Women to Improve Birth Outcomes: A Cluster-Randomized Controlled Trial in Rural Malawi.

Background: Inadequate maternal dietary intakes remain a public health challenge in low-income countries like Malawi and can cause adverse birth outcomes.

Objectives: To improve maternal dietary intakes and thus reduce the prevalence of adverse birth outcomes in rural Malawi.

Methods: We performed a 2-armed (1:1) cluster-randomized controlled trial in Southern Malawi, enrolling pregnant women at gestational age 12-18 wk.

Dihydroartemisinin-piperaquine versus sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy: a systematic review and individual participant data meta-analysis.

Background: High-grade resistance to sulfadoxine-pyrimethamine in East and Southern Africa has prompted numerous trials evaluating intermittent preventive treatment in pregnancy (IPTp) with dihydroartemisinin-piperaquine as an alternative to sulfadoxine-pyrimethamine.

Methods: We conducted individual participant data meta-analyses of randomised trials comparing IPTp with dihydroartemisinin-piperaquine to sulfadoxine-pyrimethamine on maternal, birth, and infant outcomes. We searched the WHO International Clinical Trials Registry Platform, ClinicalTrials.

Uptake of COVID-19 vaccine and associated factors among Health Care Workers at Queen Elizabeth Central Hospital in Malawi: A cross-section study.

Globally, the introduction of the Coronavirus Disease of 2019 (COVID-19) vaccine within one year of the pandemic brought doubts to the general population including health professionals. Even though Health Care Workers (HCWs) are at a high risk of contracting and transmitting the coronavirus due to their work, their COVID-19 vaccine uptake is unknown. This study aimed to determine the uptake of the COVID-19 vaccine and identify factors associated with uptake among HCWs at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi.

The proportion and determinants of appropriate health seeking behavior for febrile illness among caregivers of children under-five years in Butula sub-county, Busia county, Kenya.

Background: Almost 10 million children under the age of five in Kenya, die due to fever-related diseases. In Busia, a county in Kenya, malaria accounts for 13% of all child fatalities under the age of five, a number higher than any other county. This study aimed to determine (a) proportion of appropriate health-seeking behavior and (b) determinants of health-seeking behaviors (HSBs) among their caregivers in Butula Sub-County, Busia County, as reported by the caregivers.

Antibiotic Dispensing Practices Among Community Retail Pharmacies and Registered Drugstores: Results from a Simulated Client Study in Lilongwe, Malawi.

Introduction: Antimicrobial resistance (AMR) is largely driven by the inappropriate use of antibiotics. This has been attributed to the non-prescription sale of antibiotics in retail drug outlets. Despite the rising number of retail drug outlets in Malawi, the practice of drug dispensing in private pharmacies has not been evaluated.

Schools of public health as a cornerstone for pandemic preparedness and response: the Africa COVID-19 experience.

Background: The Coronavirus disease (COVID-19) pandemic caused significant morbidity and mortality in Africa, in addition to other socio-economic consequences. Across the continent, Schools of Public Health (SPHs) played several roles in supporting national, regional, and global response to the pandemic. Following a published and grey literature search, this paper reviews and analyses the contribution of SPHs in Africa during the COVID-19 pandemic.

Factors Influencing Guardians' Health-Seeking Decisions for Children With Burkitt Lymphoma in Northern and Central Malawi.

Background: The survival of children with Burkitt lymphoma (BL) in sub-Saharan Africa is disproportionately low compared to high-income countries. In Malawi, many of these children are diagnosed in advanced stages. Early and accurate diagnosis is critical to survival of children with BL.

Factors associated with access and utilization of sexual abuse emergency healthcare services among street children in Zomba, Malawi: a qualitative study.

Background: Sexual abuse among street children is a problem that renders a burden of sexually transmitted diseases, HIV infection, and early pregnancy. Literature shows that globally 95 million children experience sexual abuse with 1 in 5 girls and 1 in 7 boys exposed to sexual abuse before 18 years of age in Malawi. Malawi adopted the World Health Organization guidelines for providing emergency health services for victims of sexual abuse, which include HIV Post Exposure Prophylaxis (PEP) and Emergency Contraceptive Pills (ECP) within 72 h of exposure, Sexually Transmitted Infections (STI) treatment, and psychosocial services.

Socioeconomic disparities in Plasmodium falciparum infection risk in Southern Malawi: mediation analyses.

This study investigated the mediators of the association between socioeconomic position (SEP) and Plasmodium falciparum (Pf) infection in Southern region of Malawi. We utilized data from the 2014 International Center of Excellence for Malaria Research (ICEMR) surveys from Malawi in which blood samples of all individuals from selected households in Blantyre, Thyolo and Chikhwawa were tested for Pf parasitemia. We assessed household SEP and potential mediators - housing quality, food security, education status of household heads, and use of long-lasting Insecticide-treated nets (LLINs) and nutritional status.

Protein quality malnutrition.

Protein quality refers to the evaluation of a food or a diet based on its amino acid composition, protein digestibility, and protein bioavailability. When these parameters are specified, either through direct measurement or estimation, the amino acids provided by the diet are compared to those required by a healthy individual, and based on this comparison, an adequacy ratio or score is assigned. Two widely used protein quality scoring systems are the protein digestibility-corrected amino acid score (PDCAAS) and the digestible indispensable amino acid score (DIAAS), neither of which account for the dietary source of the protein.

Factors influencing antenatal care attendance in the eight contact era policy: a case of selected maternal health service facilities in Blantyre, Malawi.

Background: Maternal mortality in sub-Saharan Africa and Malawi remains high. Effective antenatal care (ANC) services can reduce maternal morbidity and mortality. However, attendance to ANC clinics and the quality of services provided remain a challenge.

Evaluating the impact of HIV pre-exposure prophylaxis on pregnancy, infant, and maternal health outcomes in Malawi: PrIMO study protocol.

Background: Incident HIV during the perinatal period significantly impedes elimination of Mother-to-Child HIV Transmission (eMTCT) efforts. Pre-Exposure Prophylaxis (PrEP) effectively reduces HIV acquisition, and new agents like injectable Cabotegravir (CAB-LA) offer potential advantages for pregnant and breastfeeding women. The Pregnancy, Infant, and Maternal health Outcomes (PrIMO) study will compare rates of composite adverse pregnancy outcomes, and infant adverse events, growth and neurodevelopment between mother-infant dyads receiving CAB-LA and those receiving oral PrEP in Malawi.

Comparing approaches for chemoprevention for school-based malaria control in Malawi: an open label, randomized, controlled clinical trial.

Background: School-age children in sub-Saharan Africa suffer an underappreciated burden of malaria which threatens their health and education. To address this problem, we compared the efficacy of two school-based chemoprevention approaches: giving all students intermittent preventive treatment (IPT) or screening and treating only students with detected infections (IST).

Methods: In a three-arm, open-label, randomized, controlled trial (NCT05244954) in Malawi, 746 primary school students, aged 5-19 years, were individually randomized within each grade-level to IPT (n = 249), IST with a high-sensitivity rapid diagnostic test (hs-RDT, n = 248), or control (n = 249).

High rate of uncontrolled hypertension among adults receiving integrated HIV and hypertension care with aligned multi-month dispensing in Malawi: results from a cross-sectional survey and retrospective chart review.

Introduction: People living with HIV have high rates of hypertension. Integrated HIV and hypertension care with aligned multi-month dispensing of medications (MMD) could decrease the burden of care for individuals and health systems. We sought to describe hypertension control and evaluate its association with different durations of MMD among Malawian adults receiving integrated care with aligned dispensing of antiretroviral therapy (ART) and antihypertensive medication.

"When selling anything to an audience, visible publicity is key:" experiences, barriers, and enablers to participate in a COVID-19 study in Malawi.

Background: Many studies in infectious diseases struggle to recruit participants. The SARS-CoV-2 infection, transmission dynamics, and household impact in Malawi (SCATHIM) study reported a refusal rate of 57.2%.